The impasse over a new federal-provincial health-care deal has broken as both sides close in on how to get better results from new spending, federal Health Minister Jean-Yves Duclos said Friday.
That includes agreeing to invest in the technology to improve digital health records and data collection, he said at a news conference in Ottawa.
Duclos said the tone and direction of the talks with the provinces has changed and improved in the last few weeks. He said the conversation about getting results is “stronger now than it used to be.”
“I’m quite optimistic it’s continuing to move in the right direction,” he said.
Provincial governments and the federal Liberals are far more optimistic — flat-out confident, in fact — that a new long-term health-care funding deal will be reached in time for the next federal budget in the spring.
Negotiations are in full swing for the premiers and Prime Minister Justin Trudeau to sit down in person in Ottawa to push through the final details, but no date has been finalized for that to happen.
It’s a complete turnaround from the fall, when a health ministers’ meeting in Vancouver in early November fell apart.
The provinces demanded significant increases to federal health transfers with no strings attached. The federal government insisted new funds would only flow with clear accountability measures attached.
That came as the health-care system was once again stressed beyond its limit in the face of an unexpectedly early and intense flu season and labour shortages exacerbated by COVID-19 pandemic burnout. The national shortage of children’s pain and fever medication did not help.
Provinces are responsible for health-care delivery, but Ottawa provides a direct transfer to cover some of the costs. In 2022-23 that transfer totalled $45 billion, an increase of more than 40 per cent in the last eight years.
The current funding formula ensures the annual Canada Health Transfer goes up at least three per cent a year, and by more if Canada’s economic growth is outpacing that amount. It increased 4.8 per cent between 2021-22 and 2022-23 and right now is set to rise nine per cent, to $49 billion, next year.
The provinces, which collectively spend more than 34 per cent of their budgets on health, say Ottawa foots about one-fifth of the cost of delivering public health care. They want that to increase to more than one-third.
In a December interview with The Canadian Press, Prime Minister Justin Trudeau said this negotiation for a new funding deal is a moment for governments to try and fix what is ailing the public health-care system Canadians cherish.
“It wouldn’t be the right thing to do to just throw more money at the product and sit back and watch the problem not get fixed because we didn’t use this moment to say ‘No, no, no, it’s time to improve the system in very, very real ways.’”
About a week after that interview Trudeau met with Quebec Premier François Legault in Montreal, one of the most vocal opponents to accepting any conditions with the new money.
Legault expressed optimism a deal would happen following that meeting. But the first real sign of progress came Jan. 11, when Ontario Premier Doug Ford said his government was open to providing the accountability Ottawa was asking for, as long as it was understood that provinces also needed flexibility.
Then on Jan. 18, Legault said he was also willing to move and that he and Ford had agreed to provide the data improvements the federal government wanted. He said now it’s up to Ottawa to get the other provinces on board.
The Liberal government has struck individual deals with provinces in the past, including the last time federal-provincial health funding negotiations broke down.
In 2016, when provinces were collectively balking over federal targets for home care and mental health funding, New Brunswick broke ranks and signed a bilateral deal. Other provinces then followed suit, signing individual deals of their own over the next several months.
Ford said that won’t be repeated.
“It’s not going to be a one-off for Ontario, another for someone else,” he said on Friday. “We’ve all agreed, all the premiers, we all have to work together and stay united and that’s exactly what we’re going to do.”
The federal government laid out five specific commitments they want to see, including reducing wait lists and surgical backlogs, improving access to family medicine, mental-health care, aging with dignity and modernizing health-care technology and data sharing.
That last issue was among the biggest sticking points. Duclos said Friday that it is mostly about the sharing of medical records between health providers.
He said only about one-third of health professionals can access shared data. Nurses and doctors treating someone in the emergency room can’t get quick information about their patient, such as pre-existing conditions or what medications they’re on, which can delay care and result in worse outcomes.
Only about one-third of patients also have access to their own medical records, said Duclos, which is also a barrier to allowing them to be an informed participant in their own health care.